*This schedule applies to services provided by a participating CAREINGTON General Dentist. The purpose of this schedule is to establish the maximum fee
that a General Dentist will charge for each procedure. Member is responsible for all charges at the time of service. Participating Specialists (Board Certified
or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give up to a 20% discount off of their normal fees. Fee schedules
are subject to change without prior notification to members.

*It is the Member’s responsibility to verify that the dentist is a participating Provider before seeking any treatment. Any dental procedures performed
by a non-participating dentist are not discounted and are charged at the dentist’s normal fees.

*The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment – many treatments may require more than
one dental procedure. Please consult your CAREINGTON provider for a detailed treatment plan prior to beginning any work.

*Procedures not listed on this schedule will be discounted at 20% of the General Dentist’s normal fee.
*Implants and some whitening procedures will not be discounted by all participating CAREINGTON providers. Implants and some whitening procedures will only
be discounted if the participating CAREINGTON provider has agreed to discount these procedures as part of their contract. These services will be offered,
when applicable, at a 15% discount off of the provider’s normal fee. Please call 800-290-0523 for assistance.
*If the General Dentist’s normal fee for any procedure is less than the fee listed on this schedule, the dentist will charge 20% off of their normal fee
for that procedure.
*Work in progress prior to enrollment on the dental plan must be completed by the dentist who started the work and is subject to no discount.
*CAREINGTON can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating
CAREINGTON provider. Not all types of dentists may be available in your area.

*Any procedure involving lab fees will incur additional costs. All applicable lab fees are the responsibility of the member.

*While all participating CAREINGTON providers are professionally licensed in the state in which they practice, CAREINGTON does not guarantee the quality
of service of the providers. Any quality of care concerns involving any participating CAREINGTON provider should be directed in writing to: CAREINGTON
International, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034. Please call 800-290-0523 if you have any further questions.
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